Episode Transcript
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Speaker 1 (00:00):
This is a content warning. This episode contains content regarding suicide, homicide,
and gun violence. These are challenging times, but you don't
have to navigate them alone. Welcome to How Can I Help?
(00:20):
I'm Dr Gayl Salt. I'm a clinical Associate Professor of
psychiatry at the New York Presbyterian Hospital, a psychoanalyst, and
best selling author, and I'm here every week to answer
your most pressing questions, hopefully with understanding, insight and advice. Hi,
(00:42):
this is Dr Gayl Salts, and today I'm going to
depart from my typical content of my podcast because we
have some really horrific headlines in the news and I
am hearing from parents who are really struggling to send
their children to school. They feel so anxious and their
(01:03):
child is anxious. Because everyone is aware of the school
shooting in Uvaldi. I personally was on site post the
shooting and Sandy Hook and reported numerous days actually for
the Today Show in terms of helping people with their
mental health in the aftermath, and I must say, probably
(01:28):
one of the most difficult and tragic stories that I've
ever been involved with, and in some ways, I would say, honestly,
I and the people with me never get over, and
unfortunately it seems that the numbers have only increased since
that time. That was the first startling and horrifying school shooting,
(01:50):
after which I and many people assumed that we would
increase gun control in this country and that we would
just generally do things to try to stem this tide
of gun violence. Unfortunately, that did not happen. In fact, interestingly,
(02:11):
in Scotland twenty six years ago, when there was their
first mass school shooting, that's exactly what they did. They
really tighten restrictions of all sorts in terms of gun regulation,
and in the last twenty six years since that time,
they have had zero mass school shootings. In this country, unfortunately,
(02:33):
we have had an ever increasing number of mass shootings,
including school shootings. The first refrain that I hear from
many politicians in the news is this is a mental
health problem and we need to put more money towards
mental health issues in order to solve this problem. And
(02:55):
what I have been trying to explain to politicians, who
of course do not add for my expertise, is that
while I, as a psychiatrist, would love there to be
more funds for mental health issues because we are desperately
in need, We are in a pandemic of mental health problems,
and we are woefully underfunded in so many areas. While
(03:18):
I would love that and encourage that in every way,
I also want to be exceedingly clear that will not
diminish the number of gun deaths in this country at all,
because the vast, vast, vast majority of people who commit
(03:39):
gun homicides and when they do occasionally, have a mental illness,
which is rare. And I do say rare, because we
know that the vast majority of people who commit gun
homicides are evil. They hate, they have anger, they are loners.
(04:00):
But none of those things is a mental illness. That
is not a diagnosable mental illness, and there is no
treatment in mental health care for those issues. But while
we know that, we do know first of all, that
people with mental illness are more likely to be the
victims of a crime, including death by gun, And we
(04:21):
know that the people who mostly commit these crimes, even
in the rare, rare instance, that they do have a
serious mental illness, which does occasionally happen. For example, the
movie theater shooting in Aurora, Colorado, we know that that
man had a psychotic illness. For the most part, people
who are making the decision, even if they're mentally ill
(04:46):
to kill people, do not come and see a mental
health professional. They do not seek our counsel, and they
will not make an appointment. And because we have civil
liberties in this country, we cannot find them and force
them to make an appointment. So, for the most part,
anybody who would be helped by mental health care in
(05:09):
terms of not committing this kind of crime, they do
not come to us, and we cannot make them. So
where does that leave us. I think it's really important
that people understand that we have more guns in this
country than any other industrialized country. We have the same
(05:29):
amount of mental illness in this country than every other
industrialized country, but we have more gun homicides than any
other industrialized country. It doesn't take rocket scientists to look
at those three facts and understand that access to guns
(05:52):
is one place that we could make a huge difference
in terms of on homicides. Sadly, as a psychiatrist, I
don't get to make those decisions. I'm literally called in
after the fact to try to help the remaining people
with bereavement and grief and PTSD over and over and
(06:18):
over again, and frankly, it's tragic we keep watching this
on repeat. And besides the people who are killed, there
is left in its wake this ripple effect of so
many people who are suffering trauma, PTSD, complicated grief, depression,
(06:40):
increased risk for suicide as a result of gun death
somebody that they knew or were close to. I think
that this country needs to take a good hard look
at who we're electing, what their priorities are. I know
that we value life, and we value children's lives, and
(07:01):
I see no evidence in sight of any way to
decrease these mass shootings in schools until we look at
whether it's really appropriate that any person at the age
of eighteen can have an assault weapon. We'll be right
back after this short break. Thank you for returning. I
(07:37):
think there are a couple of issues that psychiatrists can
contribute to on this discussion of gun violence. First of all,
the number one cause of death from gun violence is
actually suicide. Of all gun deaths are suicide, and we
know that having access to a gun when you are depressed,
(08:02):
or just basically ever, having access to a gun increases
the risk for suicide sixfold the point being that the
decision to die by suicide is often an impulsive one
in the moment, and the use of a method that
is the most lethal means that that person may very
(08:25):
well fulfill their choice to end their lives. It is very,
very important that people understand the signs and symptoms of
someone who is contemplating suicide, and if they recognize this,
that they call the police, who can do an assessment
and remove access to firearms. Always make sure your firearms
(08:51):
are locked and secured so that no one in your
sphere or who could even enter your home can have
access to your fire arm who sadly may be depressed
or for other reasons, contemplating suicide and make that happen.
But the remaining are homicides, and we need to think
(09:17):
about who has access to guns. So in the case
of the shooting in the Texas school and actually just
ten days before the shooting in Buffalo, New York, in
a supermarket, both of those perpetrators were eighteen years old.
We could go further back. We could look at the
Parkland shooter, also twenty years old. Many of the school
(09:41):
shootings have been committed by perpetrators who are twenty one
and under. It is important to understand that the human
brain does not fully developed its frontal lobe until about
the age of twenty four or twenty five, and that
is the part of the brain that houses judgment and consequence.
(10:06):
Part of the reason that we have the drinking age
to be twenty one. And yet we say that it
is fine for an eighteen year old, a nineteen year old,
a twenty year old whose frontal lobe is not fully
developed yet to have legal and unfettered access to an
assault weapon, amongst other weapons, a weapon that was designed
(10:29):
to be a military weapon used only in military circumstances
because you can kill so many people in such a
short amount of time, and these are the weapons that
are being used in school shootings. So I think and
I hope that policymakers will tap psychiatrists to discuss human development,
(10:54):
brain development, adolescent development, and it's impact on gun ownership
and gun access. I do think that it is important
to have policymakers tap psychiatrists to discuss mental illness and
access to gun and background checks, because right now there
(11:20):
seems to be no intent to change background checks at all.
But it is true that somebody who is considering taking
their own lives, may very well decide that on the
way out they will take other lives as well. So
it's really dangerous. I consider that person to be a
danger not only to themselves but potentially to others. To
(11:43):
have somebody be able to have access who and there
are a number of risk factors we know from the
little bit of research that we've been allowed to do
about who commits crimes with guns. And I say that
because up until very recently, for over two decades, the
CDC has been denied the ability to have any funds
(12:06):
and denied the ability to do any research when it
comes to guns that was specifically legally mandated, making it
difficult for us to have the information that we've needed
to address what is now clearly become a tremendous public
health issue. It affects so many people. Just like in
(12:29):
the days when car accidents were deemed to be and
realized to be a public health issue, we did research
and decided that we needed to legislate that people need
to wear seatbelts. We've been unable to do any of
that because we've been denied the funds and just the permission.
Even if we could find the funds to do any research,
so that has just changed. And what does emerge even
(12:52):
from past looking at this issue is that there are
high risk people for committing crimes with guns, and those
are people who have done domestic violence in the past,
who have been convicted of domestic violence and abuse, people
who have committed prior crimes that are aggressive crimes, assault
(13:14):
and battery crimes with guns in the past. We know
that if you are contemplating suicide, you may, as I said,
contemplate also homicide in certain instances not as common as
just taking your own life, but still present. We know
that many of the mass shooters who have gone in
(13:34):
and school shooters understood and had no problem with that
at the end of this they would die as well.
And so that is a group that we need to
be concerned about in terms of having access to a gun.
So in terms of background checks, we we have no
laws right now that really address these things. And of course,
again lawmakers often say to me or bring to my attention, hey,
(13:59):
why aren't you, as a psychiatrist making sure that a
person who qualifies in any way for mental illness doesn't
have access to a gun. While that would be because
you haven't given me the laws to allow me to
do anything to take a gun away from a person
short of hospitalizing them. And we do have laws about
psychiatric hospitalization. You must prove that the person is an
(14:23):
eminent threat to themselves or someone else in the moment, literally,
and a judge has to hear that in order to
hold a patient for even twenty four hours. So, because
we are a country committed to civil liberties, which I
certainly agree with, we can't easily remove a gun from
somebody or remove them from their gun. And here in
(14:48):
lies some of the problem. When we're talking about the
then diagram between mental illness, actual mental illness, and gun violence.
Parents are now in pacingly afraid of sending their children
to school, and I understand that. I think that there
is something scary, absolutely about hearing about schoolmash shootings and
(15:11):
sending your child to school even knowing there's a security
guard there, because of course you keep hearing the news
stories that there was a security guard there and it
did not prevent the shooting. I do think it's important
for parents to understand two things. One is that still
though this is horrendous and we see the numbers increasing,
it is still a rare event. It is hard to
(15:33):
keep that perspective when it is in the news so often.
So I do advise you to not constantly watch every
detail of this over and over again, and not expose
your children to this information over and over again, as
it really, at a certain point is only serving to
scare them. I do advise you to try to work
(15:54):
on your own anxiety. If you need professional help to
do so, do so. But it is important because if
you transmit anxiety in sending your child to school, they
will certainly feel anxious about going and conveying that this
is a rare event. And just like if you saw
that there was gonna be a thunderstorm today, you would
(16:16):
still send your child to school, even though there is
the outside possibility that thunderstorm could occur while they're walking
home and they could be struck by lightning. That is true,
it is true, but it is rare. It is very rare,
and this is very rare. And so there are many
things that we do each day because there are important things.
(16:37):
With the uncertainty small as it may be that something
bad could happen. The alternative is your child has a
school phobia, can't go to school, won't go to school,
and cognitively and socially they are really set back. It
(16:57):
is harmful to not go to school. So it is
important to try to remind yourself and remind your child.
This is a very very rare thing. I think there
are other things that you, as a parent can do,
which is, if this is disturbing to you and to
your child, how can you help? How can you make
your voice be heard? Can you call your local government.
(17:20):
Can you make your opinion known about what you think
should happen. Can you, together with your child, raise funds
to help organizations that are working on this problem. Helping
gives you a feeling of agency, and agency reduces anxiety.
So I would tell you as a psychiatrist, it is important.
(17:42):
It is good to be able to help in whatever
way you feel can be helpful. And so I have
been talking to parents about the importance of reducing their
own anxiety, then helping their child with their anxiety, and
then helping their child to go a school, talking with
their school about what the school's security measures are, reminding
(18:06):
your child about the security that is in place, doing
things outside of school that may help with the problem
at a local level, or at a national level for
that matter, and I think those things are important. And
while I wish that as a mental health professional, we
could help in all realms, and we certainly can help
(18:29):
in the aftermath. We know, for example, that in the
aftermath of a trauma, early intervention is everything, and in
the state of Texas, for example, early intervention for those
parents and family members is so crucial. We also sadly
(18:49):
know that Texas is fifty at a fifty in states
for mental health care. We also know that the governor recently,
very recently removed two hundred and eleven million dollars from
the mental health care budget, and so I have a
lot of concerns whether any of those people will get
any intervention or any mental health care. But again, I
(19:12):
think for all of you listening making sure that there
are enough funds for mental health care in your state,
in your community, because we do know that early intervention
in bereavement with trauma is so important and makes a
huge difference in the outcome for those family members left behind.
(19:34):
I wish that we could have input into who is
safe to have a gun, And you know, I am
not suggesting that we take away everybody's second Amendment rights.
I understand that that's important to people, and I understand
that we're going to have guns in this country, but
having access at young ages to assault weapons, frankly, having
(19:58):
access to if you're not and law enforcement or the military,
or that we have more weapons in this country than
we have members of the military. We have millions and
millions and millions of weapons owned in this country, more
than members of the military. That's very worrisome, particularly because
(20:20):
if you look at the statistics, you see that the
number of mass shootings and shootings in general in this
country just far outweigh any other country, and they skyrocket
up after the band was removed, and they continue to rise.
What doesn't continue to rise is mental health issues compared
(20:42):
to any other country. So we we have to look
at the statistics, we have to look at the numbers,
we have to look at the research that's coming out,
and we have to tackle gun violence as the public
health issue that it is. And I'm sure there will
be people listening today who will say, Hey, this is
not your issue, But I am a psychiatrist and I
(21:04):
am a physician, and this is our lane life and death,
trauma and mental health care and the effect that gun
violence is having on our country. This is my lane,
so I hope that people will understand I deviated today
from the typical podcast, but I hope people will think
(21:27):
about what they can do and what kind of voice
we can have to try to reduce gun violence and
thereby honestly reduce the need for mental health care in
this country. Thank you. Do you have a problem I
can help with? If so, email me yet? How can
I help? At Seneca women dot com. All centers remain
(21:50):
anonymous and listen every Friday too. How can I help
with me? Dr Gail's Salts